Jsu Medical, PC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

JSU MEDICAL, PC

Practice address

2121 Santa Monica Blvd
Santa Monica, CA 90404-2303

Phone

(424) 432-2304

NPI assigned

Jun 28, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jeannie Su, MDNPI 1922487800

Title

President

Phone

(424) 432-2304

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeannie Jiwon Su, M.D.

  • Urology Physician
  • Santa Monica, CA
  • NPI 1922487800

  Single Specialty

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1750068086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 BROADWAY # 109",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904012808",
            "telephone_number": "424-432-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 SANTA MONICA BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042303",
            "telephone_number": "424-432-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JSU MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-28",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "SU",
        "authorized_official_first_name": "JEANNIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "424-432-2304",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cossette Joy, MD
• Kelly Joyce
• Peter W Joyce, MD
• Ashley El Joyner
• Latasha Denise Joyner
• Tiffany Ju
• Lino Jubilado
• Lauren Haley Jue, DPT
• Stephanie Juhos
• Jules Stein Eye Institute Medical Group

• Urology Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.